Ectropion

Definition: Upper or lower eyelid that turns out and away from the eyeball. It is more common in the lower eyelid area being one of the causes of frequent tearing and red eye. It may be due for a traumatic cause or senile involution.

Blepharospasm

Blepharitis

Definition: it is acute or chronic inflammation of the lid margin creating eyelid hyperemia and a desquamation resulting in itching. Anterior blepharitis affects the outside of the eyelid where the eyelashes are located and posterior blepharitis affects the inner part where the meibonian sebaceous glands that when become infected and clogged, cause styes.

Treatments:

Blepharitis is not contagious and is usually treated with eyelid cleaning and may also be treated with an antibiotic cream.

Dry Eye

Definition: It is a multifactorial disease of the ocular surface that causes discomfort with sensation of grit, burning, itching, etc secondary to tear film instability with potential damage to the ocular surface. Altering the tear may be by fast evaporation or production deficit (being characteristic of Sjögren's syndrome).

Treatments:

A personalized treatment is applied depending on the cause and severity of dry eye. The treatment is medical with topical lubricants, anti-inflammatories, autologous serum..and in some severe cases oral treatment (tablets) is also given.(51)

Conjunctivitis

Definition: Inflammation of the conjunctiva, mucous membrane that covers the white part of the eye (sclera) and the inside of the eyelids.This inflammation can be due to various causes, being the most frequent: infections (bacterial or viral conjunctivitis) and allergic (allergic conjunctivitis).

Treatments:

Doctor, administering eye drops with anti-inflammatories, antibiotics or antihistamines depending on the cause and severity. (51)

Pinguecula / Pterygium

Definition: Pinguecula is a conjunctival benign tumor related to the exposure to the sunlight. If it grows and affects the corneal surface, it is called pterygium and can cause astigmatism and affect the visual axis.

Keratoconus

Definition: Progressive pumping (ectasia) of the cornea that typically begins in adolescence, causing a progressive loss of vision.

Treatments:

In mild cases with no progression, checks are made or vision is corrected with semi-rigid contact lenses. In cases where the cornea is increasingly deformed, it is necessary further surgery: crosslinking (3a), intrastromal rings (3b) or DALK (3c).

Keratitis

Definition: It is a corneal inflammation. There are several causes, the most common is keratitis caused by dry eye, resulting in minor injuries in the cornea surface layer. It is also common after long sun exposure or severe conjunctivitis.

Limbic Deficiency Syndrome

Definition: Stem cells on the periphery of the cornea affectation, which are responsible for the regeneration of the epithelium (most superficial layer of the cornea). This destruction of epithelial stem cells can be congenital (birth) or acquired (by a burn, a conjunctival scarring ...)

Treatments:

In mild cases, treatment is medical (tears and anti-inflammatory eye drops) (51) but in severe cases, it is necessary to resort to partial or total limbal transplantation.

Cataract

Definition: The human eye has two lenses that, acting together, focus light on the retina. The outer lens is called Cornea and internal Crystalline. Light rays that penetrate into the eye, first pass through the Cornea and then the Crystalline, to finally reach the retina. From the retina, these light rays are directed to the brain via the optic nerve in the form of electrical impulses. Crystalline is composed of water and protein. Almost everyone experiences, around age of 55-60 years, a progressive agglomeration of proteins. This process causes the lens to change color and go opaque. This clouding of the eye's natural lens (Crystalline) is called Cataract and, rather than a disease, should be considered as a natural process of aging.
Although cataracts can also be inherited or caused by disease, falls or trauma, age-related cataract is by far the most common.

Dry AMD

Definition: Macular degeneration is a age related disease in which central vision (also called "macula") is damaged. A degeneration of the central vision occurs. The macular degeneration is completely asymptomatic in the early and intermediate stages. Advanced forms usually affect central vision, ability to read or recognize the faces of people . There are two types of advanced forms: a) dry or atrophic that has a slow progression b) Wet form that has a very fast evolution.

Treatments:

1. Antiangiogenic Agent Intravitreal Injections for exuding advanced forms. (44)
2. Antioxidants have been shown to slow the progression in some groups of patients (51)

Floaters

Definition: Normally they are seen by the presence of a posterior vitreous detachment. Vitreous humor is the gel that fills the eye socket, in myopic patients or with age, the vitreous humor can become more liquid and can be moved, sometimes detaching part of adhesions that bind it to the retina. This movement of the vitreous humor can be considered as a physiological event. Floaters can be seen and sometimes flashes of lightning. Se ven moscas volantes (miodesopsias) y a veces flashes o relàmpagos (photopsia). When a sharp movement of the vitreous humor occurs, with acute presence of floaters, is essential to study the retina, especially the peripheral zone to rule out holes, tears or retinal detachment.

Treatments:

In the presence of floaters, no treatment is recommended, usually the symptoms disappear or decrease with the passage of months. Some severe cases may benefit from a pars plana vitrectomy and removal of floating bodies (9) vitrectomy pars (9).

Diabetic Retinopathy

Definition: It is the most common cause of blindness in young patients. It is characterized by affecting retinal vessels, especially small ones(capillaries) causing them to break or dilate. This causes that the blood does not properly arrive where it should, causing bleeding or serum out of the vessels. At the beginning, the disease is completely asymptomatic. In the long run causes severe visual impairment.

Treatments:

At the beginning of the disease, only is required observation. The laser (37) or intraocular injections (44) may be needed when it starts to affect vision. In very advanced cases intraocular surgery may be required by pars plana vitrectomy. (9).

Macular Hole

Definition: It consists of a total rupture of the retina layers in the central area of vision. Symptoms include distorted vision of straight lines (metamorphopsias), central vision spot (scotoma) and visual loss.

Treatments:

1. Macular hole treatment is primarily surgical, through pars plana vitrectomy (9), peeling of the internal limiting membrane and change by intraocular gas. Some cases of macular hole may benefit from intravitreal treatment with Jetrea (Alcon)(44).

Epiretinal Membrane or Macular Pucker (????)

Definition: It is characterized by the presence of abnormal tissue above the retina. It may be secondary as the cause of trauma, laser or tears in the retina, but often the cause is unknown. At the beginning it may be asymptotic, when the disease progresses, produces visual impairment and image distortion.

Retinal Vein Occlusion RVO.

Definition: It is a disease where in the retina central vein, or in any branch, appears a thrombus and the venous blood can not flow normally. Is often associated with hypertension and also glaucoma has been associated with this disease. It produces central visual loss or loss in a vision field.

Treatments:

The treatments that have proven most effective have been intravitreal injections (44), antiangiogenic agents or sustained release corticosteroids (51).

Retinitis Pigmentosa RP

Definition: It is a progressive degeneration of the retina, usually related to genetic problems, it is characterized by progressive death of photoreceptors, especially rod cells, responsible for night and peripheral vision. The disease causes a loss of peripheral vision (gun-barrel vision) and night blindness.

Treatments:

At present there are no treatments for this disease, control of possible complications or other associated problems such as cataracts or macular edema is recommended. It is also recommended genetic disease assessment.

Uveitis

Definition: They are inflammations of the uvea (a structure formed by the iris, ciliary body and choroid). The uveitis group includes a heterogeneous spectrum of pathologies, according to their location and etiology. The main causes of uveitis are diseases that affect the rest of the body, especially infectious and autoimmune diseases. The most common symptoms are pain, decreased visual acuity and sensitivity to light. Uveitis usually requires a multidisciplinary approach, we perform together with internal medicine.

Treatments:

Anterior uveitis is treated with anti-inflammatory eye drops (51)

Noninfectious posterior uveitis is fought with cortisone administered orally or by injections around the eye (51)

Uveitis associated with a chronic process may require the use of immunomodulatory drugs (51)

Hyperopia

Definition
Refractive error caused mainly by a small length of the eye, causing a blurring of the image on the retina. People experience this visual problem in different ways according to age: a young person can compensate or suffer eyestrain, while an older person chan start with problems with near vision, and also at the end suffer difficulties in distant vision.

Astigmatism

Definition: Refractive error caused by a non-sphericity of the ocular dioptrics, for example, a difference of curvature between two perpendicular meridians of the cornea. People who experience this defect have distorted vision at all distances. It is usually stable throughout life and can be accompanied by myopia or hyperopia.

Amblyopia or “Lazy Eye”

Definition: Is the lack of development of vision that is not corrected with glasses. It is important to diagnose to make the first visit with children at 3 years of age, because if treated early, has a solution.

Strabismus

Definition: Eye condition where the optical axes can not be directed to the same object, due to contraction or relaxation of one or more muscles of the eyeball. Each eye looks in a different direction, "twists an eye or both" inward, out, up or down. It can be congenital, from the first months of life to 3-4 years. It can also appear in adulthood.

Diplopia or double vision

Definition: You see the same image twice in a given visual field. The result of a bad binocular alignment (Strabismus) disappears when you cover one of your eyes. It can be monocular caused by disorders of the anterior segment (cataract, dry eye.)